10-Q

 UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2013

or

o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT

For the transition period from                     to                     .

Commission file number:  0-15586

U.S. Neurosurgical, Inc.

(Exact name of registrant as specified in its charter)

Delaware	52-1842411
(State of other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

2400 Research Blvd, Suite 325, Rockville, Maryland 20850

(Address of principal executive offices)

(301) 208-8998

(Registrant's telephone number)

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Exchange Act during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.Yes  xNo  o

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (Section 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).Yes  x No  o

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company.  See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer o	Accelerated filer o
Non-accelerated filer o	Smaller reporting company x

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes  oNo  x

The number of shares of the registrant’s common stock, $0.01 par value, outstanding as of November 13, 2013 was 7,797,185.

TABLE OF CONTENTS

PART I - FINANCIAL INFORMATION	3
Item 1.  Financial Statements	3
Item 2.  Management Discussion and Analysis of Financial Condition and Results of Operations.	14
Item 3.  Quantitative and Qualitative Disclosures About Market Risk.	18
Item 4.  Controls and Procedures	18
PART II - OTHER INFORMATION	21
Item 1.  Legal Proceedings	21
Item 2.  Unregistered Sales of Equity Securities and Use of Proceeds	21
Item 3.  Defaults Upon Senior Securities	21
Item 4.  Submission of Matters to a Vote of Security Holders	21
Item 5.  Other Information	21
Item 6.  Exhibits	21
SIGNATURES	22

2

PART I - FINANCIAL INFORMATION

Item 1. Financial Statements

U.S. NEUROSURGICAL, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

	September 30,			December 31,
	2013			2012
	(UNAUDITED)
ASSETS
Current assets:
Cash and cash equivalents	$	1,452,000		$	1,450,000
Accounts receivable		-			7,000
Insurance recoveries receivable		-			3,265,000
Due from related parties		492,000			292,000
Other current assets		101,000			33,000
Total current assets		2,045,000			5,047,000
Investment in unconsolidated entities		265,000			246,000
Total assets	$	2,310,000		$	5,293,000
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses	$	103,000		$	67,000
Obligations under capital lease		-			2,271,000
Asset retirement obligations		485,000			525,000
Total current liabilities		588,000			2,863,000
Deferred income taxes		97,000			362,000
Total liabilities	$	685,000		$	3,225,000
Commitments and contingencies
Stockholders’ equity:
Common stock		78,000			78,000
Additional paid-in capital		3,101,000			3,100,000
Accumulated deficit		(1,554,000	)		(1,110,000	)
Total stockholders’ equity		1,625,000			2,068,000
Total liabilities and stockholders' equity	$	2,310,000		$	5,293,000

The accompanying notes to condensed consolidated financial statements are an integral part hereof.

3

U.S. NEUROSURGICAL, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

(UNAUDITED)

	Three Months Ended
	September 30,
	2013			2012
Revenue:
Patient revenue	$	-		$	617,000
Expenses:
Patient expenses		-			187,000
Selling, general and administrative		181,000			279,000
Total		181,000			466,000
Operating income (loss)		(181,000	)		151,000
Income (loss) from investments in unconsolidated entities - net		(3,000	)		23,000
Interest expense		(5,000	)		(53,000	)
Interest income		7,000			4,000
Income (loss) before income taxes		(182,000	)		125,000
Income tax benefit		69,000			-
Net income (loss)		(113,000	)		125,000
Basic and diluted income (loss) per share	$	(0.01	)	$	0.02
Weighted average shares outstanding		7,797,185			7,797,185

The accompanying notes to condensed consolidated financial statements are an integral part hereof.

4

U.S. NEUROSURGICAL, INC. AND SUBSIDIARY

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

	Nine Months Ended
	September 30,
	2013			2012
Revenue:
Patient revenue	$	-		$	1,681,000
Expenses:
Patient expenses		-			613,000
Selling, general and administrative		728,000			767,000
Total		728,000			1,380,000
Operating income (loss)		(728,000	)		301,000
Gain from sales of investments in unconsolidated entities		-			24,000
Income (loss) from invesment in unconsolidated entites - net		9,000			8,000
Interest expense		(5,000	)		(169,000	)
Interest income		16,000			12,000
Income (loss) before income taxes		(708,000	)		176,000
Income tax benefit		265,000			-
Net income (loss)	$	(443,000	)	$	176,000
Basic and diluted income (loss) per share	$	(0.06	)	$	0.02
Weighted average shares outstanding		7,797,185			7,797,185

The accompanying notes to condensed consolidated financial statements are an integral part hereof.

5

U.S. NEUROSURGICAL, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(UNAUDITED)

	Nine Months Ended
	September 30,
	2013			2012
Cash flows from operating activities:
Net income (loss)	$	(443,000	)	$	176,000
Adjustments to reconcile net income (loss) to net cash provided (used) by operating activities:
Depreciation and amortization		-			384,000
Gain from sales of investments in unconsolidated entites		-			(24,000	)
Income from investments in unconsolidated entites - net		(9,000	)		(8,000	)
Deferred income taxes		(265,000	)		-
Changes in:
Accounts receivable		7,000			(303,000	)
Due from related parties		(160,000	)		89,000
Other current assets		(68,000	)		(16,000	)
Accounts payable and accrued expenses		36,000			81,000
Asset retirement obligations		(40,000	)		-
Net cash provided (used) by operating activities		(942,000	)		379,000
Cash flows from investing activities:
Distribution from unconsolidated entities		-			120,000
Investments in unconsolidated entities		(50,000	)		-
Proceeds from insurance recoveries		3,265,000			-
Net cash provided by investing activities		3,215,000			120,000
Cash flows from financing activities:
Repayment of capital lease obligations		(2,271,000	)		(400,000	)
Net change in cash and cash equivalents		2,000			99,000
CASH AND CASH EQUIVALENTS - BEGINNING OF PERIOD		1,450,000			830,000
CASH AND CASH EQUIVALENTS - END OF PERIOD	$	1,452,000		$	929,000
Supplemental disclosures of cash flow information:
Cash paid for
Interest	$	5,000		$	169,000
Supplemental disclosure of noncash investing and financing activities
Sales proceeds from sale of member interests in unconsolidated entities included in due from related parties	$	-		$	112,000
Investment in unconsolidated entities included in due from related parties	$	-		$	28,000
Distributions from unconsolidated entities included in due from related parties	$	40,000		$	-

The accompanying notes to condensed consolidated financial statements are an integral part hereof.

6

U.S. NEUROSURGICAL, INC. AND SUBSIDIARIES

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

Note A - Basis of Preparation

The accompanying condensed consolidated financial statements of U.S. Neurosurgical and subsidiaries (“USN” or the “Company”) at September 30, 2013, and for the three and nine months ended September 30, 2013 and 2012, are unaudited.  However, in the opinion of management, such statements include all adjustments necessary for a fair statement of the information presented therein.  The balance sheet at December 31, 2012 has been derived from the audited financial statements at that date appearing in the Company's Annual Report on Form 10-K.

Pursuant to accounting requirements of the Securities and Exchange Commission applicable to quarterly reports on Form 10-Q, the accompanying condensed consolidated financial statements and notes do not include all disclosures required by accounting principles generally accepted in the United States of America for complete financial statements.  Accordingly, these statements should be read in conjunction with the Company's most recent annual financial statements.

Consolidated results of operations for interim periods are not necessarily indicative of those to be achieved for full fiscal years.

Note B – Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration

USN opened its New York gamma knife treatment center in July 1997 on the campus of New York University (“NYU”) Medical Center.  The Company installed a new Leksell gamma knife, the PERFEXION model, at the NYU Medical Center in March 2009 in replacement of the older gamma knife equipment.  In connection with this upgrade, the Company modified its arrangement with NYU to extend the term for 12 years from March 2009.

In October 2012, the Company’s facility at NYU was totally destroyed as a result of flooding from Hurricane Sandy. The gamma knife had to be removed to prevent any cobalt leakage that might occur due to rusting of the equipment. The emergency removal cost was $525,000. The Company paid a lease settlement of the outstanding principal balance only and received from insurance coverage $930,000 above the lease principal payments and emergency removal costs.

The Company is in the process of finalizing arrangements with NYU regarding the restoration of the gamma knife center and the Company’s long term contract with NYU.  Initial steps are being taken to prepare space for the center in the Tisch Hospital of NYU Langone Medical Center where the replacement Leksell PERFECTION gamma knife will be located.  It is currently estimated that the center will be open and treating patients by March 2014.

7

It is currently expected that the term of the agreement with NYU will remain the same, terminating at the end of March 2021.  The Company has obtained a commitment for lease financing in the amount of $4.6 million for the purchase of the replacement equipment as well as the cost of the construction required at the relocated site.

Note C – The Southern California Regional Gamma Knife Center

During 2007, the Company managed the formation of the Southern California Regional Gamma Knife Center at San Antonio Community Hospital (“SACH”) in Upland, California.  The Company participates in the ownership and operation of the center through its wholly-owned subsidiary USN Corona, Inc. (“USNC”).  Corona Gamma Knife, LLC (“CGK”) is party to a 14-year agreement with SACH to renovate space in the hospital and install and operate a Leksell PERFEXION gamma knife.  CGK leased the gamma knife from Neuro Partners, LLC, which holds the gamma knife equipment.  In addition to returns on its ownership interests, USNC expects to receive fees for management services relating to the facility.

USNC is a 20% owner of Neuro Partners, LLC and owns 39% of CGK.

USNC is a 20% guarantor on Neuro Partners, LLC’s seven-year lease with respect to the gamma knife equipment and certain leasehold improvements at SACH.  The outstanding balance on the lease obligations was $2,456,000 at September 30, 2013.  In 2016, Neuro Partners, LLC has the option to purchase the gamma knife for $490,000.

Construction of the SACH gamma knife center was completed in December 2008 and the first patient was treated in January 2009.  The project has been funded principally by outside investors.  While the Company has led the effort in organizing the business and overseeing the development and operation of the SACH center, its investment to date in the SACH center has been minimal.

Neuro Partners, LLC and CGK are considered to be variable interest entities of the Company.  However, as the Company is not deemed to be the primary beneficiary of Neuro Partners, LLC and CGK, since it does not have the power to direct the activities that most significantly affect their economic performance, certain disclosures are required rather than consolidation.

The Company has not recorded its share of the income (loss) of Neuro Partners, LLC and CGK due to the fact that the Company’s share of cumulative losses has exceeded its investment in these entities.

8

The following tables present the aggregation of summarized financial information of Neuro Partners, LLC and CGK:

Neuro Partners, LLC and CGK Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013			2012
Patient revenue	$	856,000		$	810,000
Rental income		666,000			666,000
Net sales	$	1,522,000		$	1,476,000
Net income (loss)	$	(72,000	)	$	3,000
USNC's equity in income (loss) of Neuro Partners, LLC and CGK	$	(29,000	)	$	5,000

	Three Months Ended
	September 30,
	2013			2012
Patient revenue	$	253,000		$	294,000
Rental income		222,000			222,000
Net sales	$	475,000		$	516,000
Net loss	$	(69,000	)	$	(95,000	)
USNC's equity in loss of Neuro Partners, LLC and CGK	$	(23,000	)	$	(35,000	)

Neuro Partners, LLC and CGK Condensed Balance Sheet Information

	September 30,			December 31,
	2013			2012
Current assets	$	522,000		$	468,000
Noncurrent assets	$	1,785,000		$	2,261,000
Total assets	$	2,307,000		$	2,729,000
Current liabilities	$	1,159,000		$	442,000
Noncurrent liabilities	$	1,829,000		$	2,896,000
Equity	$	(681,000	)	$	(609,000	)
Total liabilities and equity	$	2,307,000		$	2,729,000

9

Note D – Florida Oncology Partners

During the quarter ended September 30, 2010, the Company participated in the formation of Florida Oncology Partners, LLC (“FOP”) and Florida Oncology Partners RE, LLC (“FOPRE”), which operates a cancer center located in West Kendall (Miami), Florida.  The center diagnoses and treats patients utilizing a Varian Rapid Arc linear accelerator and a GE CT scanner. USNC originally invested $200,000 for 20% ownership interest in FOP and FOPRE. The remaining 80% is owned by other outside investors. The center opened and treated its first patient in May 2011. During 2012 and 2013, FOP made several distributions that reduced the Company’s investment significantly.  The Company’s recorded investment in FOP and FOPRE is $127,000 and $135,000 at September 30, 2013 and December 31, 2012, respectively.

During 2011, FOP entered into a capital lease with Key Bank for approximately $5,600,000. Under the terms of the capital lease, USNC agreed to guarantee 20% of the outstanding lease obligation in the event of default.  The outstanding balance on the lease obligation was $4,416,000 at September 30, 2013.

In June 2012, FOPRE completed the financing agreement to purchase the building that is occupied by FOP.  The amount of the loan was $1,534,275 to be paid at a monthly rate of approximately $8,500 for 120 months with the final payment due on June 15, 2022.  USNC is the guarantor of 20% of the outstanding balance of this loan, which was $1,494,000 at September 30, 2013.

10

The following tables present the aggregation of summarized financial information of FOP and FOPRE:

FOP and FOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013		2012
Patient revenue	$	2,120,000	$	2,322,000
Rental income	$	135,000	$	45,000
Net sales	$	2,255,000	$	2,367,000
Net income	$	185,000	$	375,000
USNC's equity in income of FOP and FOPRE	$	37,000	$	75,000

	Three Months Ended
	September 30,
	2013		2012
Patient revenue	$	651,000	$	839,000
Rental income	$	45,000	$	45,000
Net sales	$	696,000	$	884,000
Net income	$	81,000	$	189,000
USNC's equity in income of FOP and FOPRE	$	16,000	$	38,000

FOP and FOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	879,000	$	919,000
Noncurrent assets	$	5,958,000	$	6,374,000
Total assets	$	6,837,000	$	7,293,000
Current liabilities	$	1,178,000	$	965,000
Noncurrent liabilities	$	5,104,000	$	5,734,000
Equity	$	555,000	$	594,000
Total liabilities and equity	$	6,837,000	$	7,293,000

11

Note E – Boca Oncology Partners

During the quarter ended June 30, 2011, the Company participated in the formation of Boca Oncology Partners, LLC (“BOP”), for the purpose of owning and operating a cancer center in Boca Raton, Florida.  In June 2011, Boca Oncology Partners RE, LLC (“BOPRE”), an affiliated entity, purchased a 20% interest in a medical office building in West Boca, Florida in which BOP operates.  BOP occupies approximately 6,000 square feet of the 32,000 square foot building.  The Company’s wholly-owned subsidiary, USNC invested $225,000 initially and had a 22.5% interest in BOP and BOPRE.  In January 2012, an additional investor purchased 50% of the partnership reducing the Company’s ownership to 11.25%.  The Company loaned the proceeds of $56,250 back to BOP as a 5 year note at 7% interest. The remaining 88.75% is owned by other outside investors.  In June 2012, BOPRE purchased 3.75% of Boca West IMP from another investor and then sold 31.5% of BOPRE to a new investor. The proceeds of $28,000 were loaned to BOP and USNC’s investment in BOPRE was reduced to 15.4%.

Due to the outstanding loans, BOP is considered to be a variable interest entity of the Company.  However, as the Company is not deemed to be the primary beneficiary of BOP, since it does not have the power to direct the activities that most significantly affect its economic performance; certain disclosures are required rather than consolidation.  The center opened in August 2012.

The Company’s share of cumulative losses associated with its investment in BOP has exceeded its investment and accordingly the Company has not recognized income or loss for such investment in the periods reported.  The Company’s recorded investment in BOPRE is $111,000 at September 30, 2013 and December 31, 2012.

12

The following tables present the aggregation of summarized financial information of BOP and BOPRE:

BOP and BOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013			2012
Patient revenue	$	1,627,000		$	8,000
Net loss	$	(8,000	)	$	(445,000	)
USNC's equity in loss in BOP and BOPRE	$	(1,000	)	$	(50,000	)

	Three Months Ended
	September 30,
	2013		2012
Patient revenue	$	508,000	$	8,000
Net income (loss)	$	86,000	$	(300,000	)
USNC's equity in income (loss)in BOP and BOPRE	$	10,000	$	(34,000	)

BOP and BOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	248,000	$	289,000
Noncurrent assets	$	2,591,000	$	2,897,000
Total assets	$	2,839,000	$	3,186,000
Current liabilities	$	148,000	$	308,000
Noncurrent liabilities	$	2,191,000	$	2,368,000
Equity	$	500,000	$	510,000
Total liabilities and equity	$	2,839,000	$	3,186,000

13

Note F – Broward Oncology Partners

In January 2013, the Company formed Broward Oncology Partners, LLC (“BROP”) with other outside investors. The Company invested $50,000 in late April 2013 for a 12.5% ownership interest in BROP.  BROP operates a radiation oncology center in Fort Lauderdale, Florida under a lease from Tenet Health Services. BROP began operations in February 2013.  The facility is undergoing renovation and continues to operate on a limited basis during construction.

Revenues for BROP through September 30, 2013 were $249,000 and after expenses BROP has reported a loss of $184,000.  The Company recognized a loss of $19,000 for the third quarter of 2013 and its recorded investment in BROP is $27,000.

Note G – Income Taxes

The Company’s income tax rate, which includes federal and state income taxes, was approximately 37% for the three and nine months ending September 30, 2013.  The Company recorded income tax benefit of $69,000 and $265,000 for the three and nine months ended September 30, 2013, respectively, as a result of the losses incurred in those periods.

Item 2. Management Discussion and Analysis of Financial Condition and Results of Operations.

Critical Accounting Policies

The condensed consolidated financial statements of U.S. Neurosurgical, Inc. and subsidiaries (“USN” or the “Company”) have been prepared in accordance with accounting principles generally accepted in the United States of America.  As such, some accounting policies have a significant impact on amounts reported in the condensed consolidated financial statements.  A summary of those significant accounting policies can be found in Note B to the Consolidated Financial Statements, in our 2012 Annual Report on Form 10-K.  In particular, judgment is used in areas such as determining and assessing possible asset impairments.

The following discussion and analysis provides information which the Company’s management believes is relevant to an assessment and understanding of the Company’s results of operations and financial condition. This discussion should be read in conjunction with the condensed consolidated financial statements and notes thereto appearing elsewhere herein.

Results of Operation

Three Months Ended September 30, 2013 Compared to Three Months Ended September 30, 2012

There was no patient revenue or expenses for the quarter ended September 30, 2013 as a result of the destruction of the NYU gamma knife facility in October 2012. Patient revenue and expenses for the quarter ended September 30, 2012 were $617,000 and $187,000 respectively.

Selling, general and administrative expense of $181,000 for the third quarter of 2013 was 35% less than the $279,000 incurred during the comparable period in 2012.  The decrease in SG&A expenses was primarily due to a decrease in professional expenses and a reimbursement of $61,000 received in 2013 for maintenance and lease payments made with respect to the NYU Gamma Knife in 2012.

14

The Company incurred $5,000 in interest expense in the third quarter of 2013. The framework for a loan arrangement for the construction of the gamma knife suite has been secured and interest is being paid on the services that have begun, mainly the removal of the destroyed gamma knife and related equipment.

For the three months ended September 30, 2013, the Company reported a net loss of $113,000 as compared to net income of $125,000 for the same period a year earlier.

Nine Months Ended September 30, 2013 Compared to Nine Months Ended September 30, 2012

There was no patient revenue or expenses for the nine months ended September 30, 2013 as a result of the destruction of the NYU gamma knife facility in October 2012.  The Company currently expects the facility to reopen by March 2014.  Patient revenue and expenses for the nine months ended September 30, 2012 were $1,681,000 and $613,000 respectively.

Selling, general and administrative expense of $728,000 for the first nine months of 2013 was 5% lower than the $767,000 incurred in the same period during the previous year.  The decrease in expenses was mostly due to the decrease in professional expenses, insurance costs and a reimbursement of $61,000 received in 2013 for maintenance and lease payments made with respect to the NYU Gamma Knife in 2012.

The Company incurred minimal interest expense in the first nine months of 2013.

For the nine months ended September 30, 2013, the Company reported a net loss of $443,000 compared to net income of $176,000 for the same period a year earlier.

Liquidity and Capital Resources

At September 30, 2013, the Company had working capital of $1,457,000 as compared to $2,184,000 at December 31, 2012.  This decrease was due to the fact there was no revenue during the first nine months of 2013. Cash and cash equivalents at September 30, 2013 were $1,452,000 as compared to $1,450,000 at December 31, 2012.

Net cash used by operating activities for the nine months ended September 30, 2013 was $942,000 as compared to the $379,000 provided by operating activities in the same period a year earlier.  Again, these amounts were affected by the destruction of the NYU gamma knife.  Net loss from operations for the nine months ended September 30, 2013 includes no depreciation and amortization as compared to $384,000 the same nine month period in 2012.  In addition, net loss from operations reflected an income tax benefit of $265,000 for the nine months ended September 30, 2013 as compared to the comparable period in 2012 in which there were no deferred income tax adjustments.  Accounts receivable decreased $7,000 during the first nine months of 2013 as compared to an increase of $303,000 during the same period in 2012, while accounts payable increased $36,000 during the first nine months of 2013 as compared to an increase of $81,000 in the prior period.  Additionally, due from related parties rose during the nine months ended September 30, 2013 by $160,000 as compared to a repayment of $89,000 in the comparable period in 2012.

15

With respect to investing activities, the Company received $3,265,000 in insurance proceeds related to the destruction of the NYU gamma knife.  The Company also made a $50,000 investment in Broward Oncology Partners, LLC.  With respect to financing activities, the Company paid $2,271,000 towards its capital lease obligations during the nine months ended September 30, 2013 as compared to $400,000 in the same period a year ago. The increased amount was the result of the destruction and subsequent payoff of the gamma knife lease.

Due to the disruption caused by the flooding from Hurricane Sandy, the Company will not receive revenues from the NYU center until it reopens and is able to accept patients for treatment, which is not expected to occur until March 2014.  In addition, the Company will be required to make significant expenditures in connection with the installation of the gamma knife and the construction of the newly relocated facility at NYU.

It is expected that the term of the agreement with NYU will remain the same, terminating at the end of March 2021.  The Company has obtained a commitment for lease financing in the amount of $4.6 million for the purchase of the replacement equipment as well as the cost of the construction required at the relocated site.

Risk Factors

We desire to take advantage of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995.  The following factors, as well as the factors listed under the caption “Risk Factors” in Annual Report on our Form 10-K for the fiscal year ended December 31, 2012, have affected or could affect our actual results and could cause such results to differ materially from those expressed in any forward-looking statements made by us.  Investors should carefully consider these risks and speculative factors inherent in and affecting our business and an investment in our common stock.

Reliance on Business of the New York University Gamma Knife Center; Recent Destruction of Equipment and Discontinuation of Business at NYU.  While it is the Company’s objective to expand activities to additional cancer centers that rely on a broad range of diagnostic and radiation treatments, the Company has relied on the NYU gamma knife for substantially all of its revenue.  In recent periods, services provided at NYU have represented over 90% of the Company’s revenues.  Unless and until the Company is successful in building its activities at other centers and at new locations, disruptions at NYU could have a materially adverse effect on the Company.

In October 2012, the Company’s facility at NYU was totally destroyed as a result of flooding from Hurricane Sandy.  The gamma knife had to be removed to prevent cobalt leakage that might occur due to rusting of the equipment.  While the Company is making progress with NYU regarding the reconstruction of the facility, targeting a reopening by March 2014, there can be no assurance that the facility will reopen in a timely manner.  Moreover, even if the Company is successful in reopening the newly relocated center at NYU as currently planned, it may take additional time to achieve the level of patient volume that the center was handling prior to the disruption.

16

The Company has obtained a commitment for lease financing in the amount of $4.6 million for the purchase of the replacement equipment and for some construction and other costs associated with the damaged machine removal and new machine installation. However, the Company will incur additional costs relating to the reconstruction of the center at NYU, some of which may be substantial and will not be covered by insurance.

The Company anticipates that these factors will result in significant operating losses for the next several quarters.

Availability of Working Capital.  To date, we have earned sufficient income from operations to fund periodic operating losses and support efforts to pursue new gamma knife or other types of cancer treatment centers.  The Company expects to incur losses for the next several quarters due to the destruction of the NYU Gamma Knife.  Should losses continue for an extended period of time, or should the actual construction costs incurred materially exceed forecasts, we will be required to seek additional capital to support continued operations and the development of new centers, but we cannot assure you, however, that we will be able to raise such additional capital as and when required.

Disclosure Regarding Forward Looking Statements

The Securities and Exchange Commission encourages companies to disclose forward looking information so that investors can better understand a company's future prospects and make informed investment decisions.  This document contains such "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995, particularly statements anticipating future growth in revenues and cash flow.  Words such as "anticipates," "estimates," "expects," "projects," "targets," "intends," "plans," "believes," "will be," "will continue," "will likely result," and words and terms of similar substance used in connection with any discussion of future operating or financial performance identify such forward-looking statements.  Those forward-looking statements are based on management's present expectations about future events.  As with any projection or forecast, they are inherently susceptible to uncertainty and changes in circumstances, and the Company is under no obligation to (and expressly disclaims any such obligation to) update or alter its forward-looking statements whether as a result of such changes, new information, future events or otherwise.

The Company operates in a highly competitive and rapidly changing environment and in businesses that are dependent on our ability to: achieve profitability; increase revenues; sustain our current level of operations; maintain satisfactory relations with business partners; attract and retain key personnel; maintain and expand our strategic alliances; and protect our intellectual property.  The Company's actual results could differ materially from management's expectations because of changes in such factors.  New risk factors can arise and it is not possible for management to predict all such risk factors, nor can it assess the impact of all such risk factors on the Company's business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements.  Given these risks and uncertainties, investors should not place undue reliance on forward-looking statements as a prediction of actual results.

17

Investors should also be aware that while the Company might, from time to time, communicate with securities analysts, it is against the Company's policy to disclose to them any material non-public information or other confidential commercial information. Accordingly, investors should not assume that the Company agrees with any statement or report issued by any analyst irrespective of the content of the statement or report. Furthermore, the Company has a policy against issuing or confirming financial forecasts or projections issued by others.  Thus, to the extent that reports issued by securities analysts or others contain any projections, forecasts or opinions, such reports are not the responsibility of the Company.

In addition, the Company’s overall financial strategy, including growth in operations, maintaining financial ratios and strengthening the balance sheet, could be adversely affected by increased interest rates, construction delays or other transactions, economic slowdowns and changes in the Company’s plans, strategies and intentions.

Item 3. Quantitative and Qualitative Disclosures About Market Risk.

Not applicable.

Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in the Company's reports under the Securities Exchange Act of 1934 is recorded, processed, summarized and reported within the time periods specified in the SEC's rules and forms, and that such information is accumulated and communicated to our management, as appropriate, to allow timely decisions regarding required disclosure.  Management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives, and management necessarily was required to apply its judgment in evaluating the cost-benefit relationship of possible controls and procedures.  We do realize that we are a very small company and as a small company with only the officers and directors participating in the day to day management, with the ability to override controls, each officer and director has multiple positions and responsibilities that would normally be distributed among several employees in larger organizations with adequate segregation of duties to ensure the appropriate checks and balances.  Because the Company does not currently have a separate chief financial officer, the Chief Executive Officer performs these functions with the support of one of the Company’s outside directors who assists in the reporting and disclosure process (the “Lead Director”).

18

Our management evaluated the effectiveness of the design and operation of the Company’s disclosure controls and procedures (as such term is defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934) as of the end of the period covered by this report.  Based upon that evaluation the Company’s Chief Executive Officer concluded that the Company’s disclosure controls and procedures were not effective as of the end of the period covered by this report for the information required to be disclosed by the Company in the reports it files or submits under the Securities Exchange Act of 1934, as amended, to be recorded, processed, summarized and reported within the time periods specified in the Securities and Exchange Commission’s rules and forms, due to the material weakness in internal control over financial reporting described below.

Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) under the Securities Exchange Act of 1934).  Internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with accounting principles generally accepted in the United States of America.  The Company’s internal control over financial reporting includes those policies and procedures that:

(i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company;

(ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with accounting principles generally accepted in the United States of America, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management and directors of the Company; and

(iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the Company’s assets that could have a material effect on the financial statements.

Because of inherent limitations, internal control over financial reporting may not prevent or detect misstatements.  Therefore, even those systems determined to be effective can provide only reasonable assurance of achieving their control objectives.

19

Our management assessed the effectiveness of the Company’s internal control over financial reporting as of September 30, 2013. In making this assessment, management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission (COSO) in Internal Control-Integrated Framework. A material weakness is a control deficiency, or a combination of control deficiencies in internal controls over financial reporting, such that there is a reasonable possibility that a material misstatement of annual or interim financial statements will not be prevented or detected on a timely basis. In connection with the assessment described above, management identified the following material weakness as of September 30, 2013: the Company did not maintain sufficient qualified personnel with the appropriate level of knowledge, experience and training in the application of accounting principles generally accepted in the United States of America and in internal controls over financial reporting commensurate with its financial reporting requirements. Specifically, effective controls were not designed and in place to ensure that the Company maintained, or had access to, appropriate resources with adequate experience and expertise in the area of financial reporting for transactions such as investments in unconsolidated entities and income taxes. The Company is in the process of considering steps to remediate this material weakness.

Changes in Internal Control over Financial Reporting

While there have not been any changes in the Company’s internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) during the fiscal quarter ended September 30, 2013, management is in the process of developing plans to remediate the material weakness identified above.

20

PART II - OTHER INFORMATION

Item 1. Legal Proceedings

None

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

Not applicable.

Item 3. Defaults Upon Senior Securities

Not applicable.

Item 4. Submission of Matters to a Vote of Security Holders

Not applicable.

Item 5. Other Information

Not applicable.

Item 6. Exhibits

31.1 Certification of President and Chief Executive Officer (Principal Executive Officer and Principal Financial Officer) pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002, filed herewith.

32.1 Certification of President and Chief Executive Officer (Principal Executive Officer and Principal Financial Officer) pursuant to Rule 13a-14(b) of the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, filed herewith.

101 Interactive Data Files providing financial information from the Registrant’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2013 in XBRL (eXtensible Business Reporting Language).  Pursuant to Regulation 406T of Regulation S-T, these interactive data files are deemed not filed or part of a registration statement or prospectus for purposes of Section 11 or 12 of the Securities Act of 1933, as amended, or Section 18 of the Securities Exchange Act of 1934, as amended, and are otherwise not subject to liability.

21

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

	U.S. Neurosurgical, Inc.
	(Registrant)
Date:  November 14, 2013	By:	/s/ Alan Gold
		Alan Gold
		Director, President and Chief Executive Officer and Principal Financial Officer of the Registrant

22

EX-31.1

EXHIBIT 31.1

CERTIFICATION OF PRESIDENT AND CHIEF EXECUTIVE OFFICER

(PRINCIPAL EXECUTIVE OFFICER AND PRINCIPAL FINANCIAL OFFICER)

PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Alan Gold, certify that:

1. I have reviewed this Report on Form 10-Q of U.S. Neurosurgical, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. I am responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e))and internal control over financial reporting (as defined in Exchange Act Rules 13a–15(f) and 15d–15(f)) for the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under my supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to me by others within those entities, particularly during the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under my supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures,and presented in this report my conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and;

5. I have disclosed, based on my most recent evaluationof internal control over financial reporting, to the registrant’s auditors and the audit committee of registrant’s board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonable likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date:  November 14, 2013	/s/ Alan Gold
	Alan Gold
	President & Chairman of the Board
	(Principal Executive Officer and Principal Financial Officer)

EX-32.1

EXHIBIT 32.1

Certificate pursuant to 18 U.S.C. Section 1350,

as adopted pursuant to Section 906 of the

Sarbanes-Oxley Act of 2002

In connection with the Quarterly Report of U.S. Neurosurgical, Inc. on Form 10-Q for the period ending September 30, 2013 as filed with the Securities and Exchange Commission on the date hereof (the “Report”), I, Alan Gold, President and Chief Executive Officer of U.S. Neurosurgical, Inc., certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of U.S. Neurosurgical, Inc.

/s/ Alan Gold

Alan Gold

President and Chief Executive Officer

(Principal Executive Officer

and Principal Financial Officer)

November 14, 2013

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Florida Oncology Partners (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012	Jun. 30, 2012	Sep. 30, 2010
Schedule of Equity Method Investments [Line Items]
Recorded investments	$ 265,000		$ 265,000		$ 246,000
Outstanding lease obligation	4,416,000		4,416,000
FOP and FOPRE Condensed Income Statement Information [Abstract]
Patient revenue	0	617,000	0	1,681,000
USNC's equity in income (loss)	(3,000)	23,000	9,000	8,000
FOP and FOPRE [Member]
Schedule of Equity Method Investments [Line Items]
Recorded investments	127,000		127,000		135,000		200,000
Ownership percentage (in hundredths)	20.00%		20.00%
Ownership percentage by outside investors (in hundredths)			80.00%
Capital leases, amount	5,600,000		5,600,000
Percentage of guarantee obligations (in hundredths)			20.00%
Outstanding Loan	1,494,000		1,494,000			1,534,275
Loan amount to be paid in monthly basis			8,500
Debt maturity period			120 months
Maturity date			Jun. 15, 2022
FOP and FOPRE Condensed Income Statement Information [Abstract]
Patient revenue	651,000	839,000	2,120,000	2,322,000
Rental income	45,000	45,000	135,000	45,000
Net sales	696,000	884,000	2,255,000	2,367,000
Net income	81,000	189,000	185,000	375,000
USNC's equity in income (loss)	16,000	38,000	37,000	75,000
FOP and FOPRE Condensed Balance Sheet Information [Abstract]
Current assets	879,000		879,000		919,000
Noncurrent assets	5,958,000		5,958,000		6,374,000
Total assets	6,837,000		6,837,000		7,293,000
Current liabilities	1,178,000		1,178,000		965,000
Noncurrent liabilities	5,104,000		5,104,000		5,734,000
Equity	555,000		555,000		594,000
Total liabilities and equity	$ 6,837,000		$ 6,837,000		$ 7,293,000

XML

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) (USD $)	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Cash flows from operating activities:
Net income (loss)	$ (443,000)	$ 176,000
Adjustments to reconcile net income (loss) to net cash provided (used) by operating activities:
Depreciation and amortization	0	384,000
Gain from sales of investments in unconsolidated entities	0	(24,000)
Income from investments in unconsolidated entities - net	(9,000)	(8,000)
Deferred income taxes	(265,000)	0
Changes in:
Accounts receivable	7,000	(303,000)
Due from related parties	(160,000)	89,000
Other current assets	(68,000)	(16,000)
Accounts payable and accrued expenses	36,000	81,000
Asset retirement obligations	(40,000)	0
Net cash provided (used) by operating activities	(942,000)	379,000
Cash flows from investing activities:
Distribution from unconsolidated entities	0	120,000
Investment in unconsolidated entities	(50,000)	0
Proceeds from insurance recoveries	3,265,000	0
Net cash provided by investing activities	3,215,000	120,000
Cash flows from financing activities:
Repayment of capital lease obligations	(2,271,000)	(400,000)
Net change in cash and cash equivalents	2,000	99,000
CASH AND CASH EQUIVALENTS - BEGINNING OF PERIOD	1,450,000	830,000
CASH AND CASH EQUIVALENTS - END OF PERIOD	1,452,000	929,000
Cash paid for
Interest	5,000	169,000
Supplemental disclosures of noncash investing and financing activities:
Sales proceeds from sale of member interests in unconsolidated entities included in due from related parties	0	112,000
Investment in unconsolidated entities included in due from related parties	0	28,000
Distribution from unconsolidated entities included in due from related parties	$ 40,000	$ 0

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Broward Oncology Partners

9 Months Ended

Sep. 30, 2013

Broward Oncology Partners [Abstract]

Broward Oncology Partners

Note F – Broward Oncology Partners

In January 2013, the Company formed Broward Oncology Partners, LLC ("BROP") with other outside investors. The Company invested $50,000 in late April 2013 for a 12.5% ownership interest in BROP.  BROP operates a radiation oncology center in Fort Lauderdale, Florida under a lease from Tenet Health Services. BROP began operations in February 2013.  The facility is undergoing renovation and continues to operate on a limited basis during construction.

Revenues for BROP through September 30, 2013 were $249,000 and after expenses BROP has reported a loss of $184,000.  The Company recognized a loss of $19,000 for the third quarter of 2013 and its recorded investment in BROP is $27,000.

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Boca Oncology Partners (Details) (USD $)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2013 sqft	Sep. 30, 2012	Sep. 30, 2013 sqft	Sep. 30, 2012	Dec. 31, 2011	Dec. 31, 2012
Schedule of Equity Method Investments [Line Items]
Percentage of interest in medical office building (in hundredths)			20.00%
Investment in BOP and BOPRE	$ 265,000		$ 265,000			$ 246,000
BOP and BOPRE Condensed Income Statement Information [Abstract]
Patient revenue	0	617,000	0	1,681,000
USNC's equity in income (loss)	(3,000)	23,000	9,000	8,000
USNC [Member]
Schedule of Equity Method Investments [Line Items]
Reduced ownership percentage (in hundredths)			11.25%
Boca Oncology Partners, LLC [Member]
Schedule of Equity Method Investments [Line Items]
Area of building (in square feet)	6,000		6,000
Amount loaned to related parties			56,250
Company loan interest rate (in hundredths)	7.00%		7.00%
Debt maturity period			5 years
Boca Oncology Partners, LLC [Member] | USNC [Member]
Schedule of Equity Method Investments [Line Items]
Amount loaned to related parties			28,000
Boca West IMP [Member]
Schedule of Equity Method Investments [Line Items]
Ownership percentage (in hundredths)	3.75%		3.75%
Boca Oncology Partners RE, LLC [Member]
Schedule of Equity Method Investments [Line Items]
Ownership percentage (in hundredths)	15.40%		15.40%
Ownership percentage by outside investors (in hundredths)			31.50%
Boca Oncology Partners RE, LLC [Member] | USNC [Member]
Schedule of Equity Method Investments [Line Items]
Ownership percentage (in hundredths)	11.25%		11.25%
BOP and BOPRE [Member]
Schedule of Equity Method Investments [Line Items]
Area of building (in square feet)	32,000		32,000
Investment in BOP and BOPRE	111,000		111,000		225,000
Ownership percentage (in hundredths)					22.50%
Additional investor purchased (in hundredths)			50.00%		20.00%
Ownership percentage by outside investors (in hundredths)			88.75%
BOP and BOPRE Condensed Income Statement Information [Abstract]
Patient revenue	508,000	8,000	1,627,000	8,000
Net income (loss)	86,000	(300,000)	(8,000)	(445,000)
USNC's equity in income (loss)	10,000	(34,000)	(1,000)	(50,000)
BOP and BOPRE Condensed Balance Sheet Information [Abstract]
Current assets	248,000		248,000			289,000
Noncurrent assets	2,591,000		2,591,000			2,897,000
Total assets	2,839,000		2,839,000			3,186,000
Current liabilities	148,000		148,000			308,000
Noncurrent liabilities	2,191,000		2,191,000			2,368,000
Equity	500,000		500,000			510,000
Total liabilities and equity	$ 2,839,000		$ 2,839,000			$ 3,186,000
BOP and USNC's [Member]
Schedule of Equity Method Investments [Line Items]
Reduced ownership percentage (in hundredths)			15.40%

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Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration

9 Months Ended

Sep. 30, 2013

Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration [Abstract]

Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration

Note B – Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration

USN opened its New York gamma knife treatment center in July 1997 on the campus of New York University ("NYU") Medical Center.  The Company installed a new Leksell gamma knife, the PERFEXION model, at the NYU Medical Center in March 2009 in replacement of the older gamma knife equipment.  In connection with this upgrade, the Company modified its arrangement with NYU to extend the term for 12 years from March 2009.

In October 2012, the Company's facility at NYU was totally destroyed as a result of flooding from Hurricane Sandy. The gamma knife had to be removed to prevent any cobalt leakage that might occur due to rusting of the equipment. The emergency removal cost was $525,000. The Company paid a lease settlement of the outstanding principal balance only and received from insurance coverage $930,000 above the lease principal payments and emergency removal costs.

The Company is in the process of finalizing arrangements with NYU regarding the restoration of the gamma knife center and the Company's long term contract with NYU.  Initial steps are being taken to prepare space for the center in the Tisch Hospital of NYU Langone Medical Center where the replacement Leksell PERFECTION gamma knife will be located.  It is currently estimated that the center will be open and treating patients by March 2014.

It is currently expected that the term of the agreement with NYU will remain the same, terminating at the end of March 2021.  The Company has obtained a commitment for lease financing in the amount of $4.6 million for the purchase of the replacement equipment as well as the cost of the construction required at the relocated site.

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Florida Oncology Partners

9 Months Ended

Sep. 30, 2013

Florida Oncology Partners [Abstract]

Florida Oncology Partners

Note D – Florida Oncology Partners

During the quarter ended September 30, 2010, the Company participated in the formation of Florida Oncology Partners, LLC ("FOP") and Florida Oncology Partners RE, LLC ("FOPRE"), which operates a cancer center located in West Kendall (Miami), Florida.  The center diagnoses and treats patients utilizing a Varian Rapid Arc linear accelerator and a GE CT scanner. USNC originally invested $200,000 for 20% ownership interest in FOP and FOPRE. The remaining 80% is owned by other outside investors. The center opened and treated its first patient in May 2011. During 2012 and 2013, FOP made several distributions that reduced the Company's investment significantly.  The Company's recorded investment in FOP and FOPRE is $127,000 and $135,000 at September 30, 2013 and December 31, 2012, respectively.

During 2011, FOP entered into a capital lease with Key Bank for approximately $5,600,000. Under the terms of the capital lease, USNC agreed to guarantee 20% of the outstanding lease obligation in the event of default.  The outstanding balance on the lease obligation was $4,416,000 at September 30, 2013.

In June 2012, FOPRE completed the financing agreement to purchase the building that is occupied by FOP.  The amount of the loan was $1,534,275 to be paid at a monthly rate of approximately $8,500 for 120 months with the final payment due on June 15, 2022.  USNC is the guarantor of 20% of the outstanding balance of this loan, which was $1,494,000 at September 30, 2013.

The following tables present the aggregation of summarized financial information of FOP and FOPRE:

FOP and FOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013			2012
Patient revenue		$	2,120,000	$	2,322,000
Rental income		$	135,000	$	45,000
Net sales		$	2,255,000	$	2,367,000
Net income		$	185,000	$	375,000
USNC's equity in income of FOP and FOPRE		$	37,000	$	75,000
	Three Months Ended
		September 30,
			2013		2012
Patient revenue		$	651,000	$	839,000
Rental income		$	45,000	$	45,000
Net sales		$	696,000	$	884,000
Net income		$	81,000	$	189,000
USNC's equity in income of FOP and FOPRE		$	16,000	$	38,000

FOP and FOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	879,000	$	919,000
Noncurrent assets	$	5,958,000	$	6,374,000
Total assets	$	6,837,000	$	7,293,000
Current liabilities	$	1,178,000	$	965,000
Noncurrent liabilities	$	5,104,000	$	5,734,000
Equity	$	555,000	$	594,000
Total liabilities and equity	$	6,837,000	$	7,293,000

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Income Taxes

9 Months Ended

Sep. 30, 2013

Income Taxes [Abstract]

Income Taxes

Note G – Income Taxes

The Company's income tax rate, which includes federal and state income taxes, was approximately 37% for the three and nine months ending September 30, 2013.  The Company recorded income tax benefit of $69,000 and $265,000 for the three and nine months ended September 30, 2013, respectively, as a result of the losses incurred in those periods.

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Boca Oncology Partners

9 Months Ended

Sep. 30, 2013

Boca Oncology Partners [Abstract]

Boca Oncology Partners

Note E – Boca Oncology Partners

During the quarter ended June 30, 2011, the Company participated in the formation of Boca Oncology Partners, LLC ("BOP"), for the purpose of owning and operating a cancer center in Boca Raton, Florida.  In June 2011, Boca Oncology Partners RE, LLC ("BOPRE"), an affiliated entity, purchased a 20% interest in a medical office building in West Boca, Florida in which BOP operates.  BOP occupies approximately 6,000 square feet of the 32,000 square foot building.  The Company's wholly-owned subsidiary, USNC invested $225,000 initially and had a 22.5% interest in BOP and BOPRE.  In January 2012, an additional investor purchased 50% of the partnership reducing the Company's ownership to 11.25%.  The Company loaned the proceeds of $56,250 back to BOP as a 5 year note at 7% interest. The remaining 88.75% is owned by other outside investors.  In June 2012, BOPRE purchased 3.75% of Boca West IMP from another investor and then sold 31.5% of BOPRE to a new investor. The proceeds of $28,000 were loaned to BOP and USNC's investment in BOPRE was reduced to 15.4%.

Due to the outstanding loans, BOP is considered to be a variable interest entity of the Company.  However, as the Company is not deemed to be the primary beneficiary of BOP, since it does not have the power to direct the activities that most significantly affect its economic performance; certain disclosures are required rather than consolidation.  The center opened in August 2012.

The Company's share of cumulative losses associated with its investment in BOP has exceeded its investment and accordingly the Company has not recognized income or loss for such investment in the periods reported.  The Company's recorded investment in BOPRE is $111,000 at September 30, 2013 and December 31, 2012.

The following tables present the aggregation of summarized financial information of BOP and BOPRE:

BOP and BOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013				2012
Patient revenue		$	1,627,000		$	8,000
Net loss		$	(8,000	)	$	(445,000	)
USNC's equity in loss in BOP and BOPRE		$	(1,000	)	$	(50,000	)
	Three Months Ended
	September 30,
			2013			2012
Patient revenue		$	508,000		$	8,000
Net income (loss)		$	86,000		$	(300,000	)
USNC's equity in income (loss) in BOP and BOPRE		$	10,000		$	(34,000	)

BOP and BOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	248,000	$	289,000
Noncurrent assets	$	2,591,000	$	2,897,000
Total assets	$	2,839,000	$	3,186,000
Current liabilities	$	148,000	$	308,000
Noncurrent liabilities	$	2,191,000	$	2,368,000
Equity	$	500,000	$	510,000
Total liabilities and equity	$	2,839,000	$	3,186,000

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CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Revenue:
Patient revenue	$ 0	$ 617,000	$ 0	$ 1,681,000
Expenses:
Patient expenses	0	187,000	0	613,000
Selling, general and administrative	181,000	279,000	728,000	767,000
Total	181,000	466,000	728,000	1,380,000
Operating income (loss)	(181,000)	151,000	(728,000)	301,000
Gain from sales of investments in unconsolidated entities			0	24,000
Income (loss) from investments in unconsolidated entities - net	(3,000)	23,000	9,000	8,000
Interest expense	(5,000)	(53,000)	(5,000)	(169,000)
Interest income	7,000	4,000	16,000	12,000
Income (loss) before income taxes	(182,000)	125,000	(708,000)	176,000
Income tax benefit	69,000	0	265,000	0
Net income (loss)	$ (113,000)	$ 125,000	$ (443,000)	$ 176,000
Basic and diluted income (loss) per share (in dollars per share)	$ (0.01)	$ 0.02	$ (0.06)	$ 0.02
Weighted average shares outstanding (in shares)	7,797,185	7,797,185	7,797,185	7,797,185

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Boca Oncology Partners (Tables) (BOP and BOPRE [Member])

9 Months Ended

Sep. 30, 2013

BOP and BOPRE [Member]

Schedule of Equity Method Investments [Line Items]

Summarized Financial Information

The following tables present the aggregation of summarized financial information of BOP and BOPRE:

BOP and BOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013				2012
Patient revenue		$	1,627,000		$	8,000
Net loss		$	(8,000	)	$	(445,000	)
USNC's equity in loss in BOP and BOPRE		$	(1,000	)	$	(50,000	)
	Three Months Ended
	September 30,
			2013			2012
Patient revenue		$	508,000		$	8,000
Net income (loss)		$	86,000		$	(300,000	)
USNC's equity in income (loss) in BOP and BOPRE		$	10,000		$	(34,000	)

BOP and BOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	248,000	$	289,000
Noncurrent assets	$	2,591,000	$	2,897,000
Total assets	$	2,839,000	$	3,186,000
Current liabilities	$	148,000	$	308,000
Noncurrent liabilities	$	2,191,000	$	2,368,000
Equity	$	500,000	$	510,000
Total liabilities and equity	$	2,839,000	$	3,186,000

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Basis of Preparation

9 Months Ended

Sep. 30, 2013

Basis of Preparation [Abstract]

Basis of Preparation

Note A - Basis of Preparation

The accompanying condensed consolidated financial statements of U.S. Neurosurgical and subsidiaries ("USN" or the "Company") at September 30, 2013, and for the three and nine months ended September 30, 2013 and 2012, are unaudited.  However, in the opinion of management, such statements include all adjustments necessary for a fair statement of the information presented therein.  The balance sheet at December 31, 2012 has been derived from the audited financial statements at that date appearing in the Company's Annual Report on Form 10-K.

Pursuant to accounting requirements of the Securities and Exchange Commission applicable to quarterly reports on Form 10-Q, the accompanying condensed consolidated financial statements and notes do not include all disclosures required by accounting principles generally accepted in the United States of America for complete financial statements.  Accordingly, these statements should be read in conjunction with the Company's most recent annual financial statements.

Consolidated results of operations for interim periods are not necessarily indicative of those to be achieved for full fiscal years.

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CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (USD $)	Sep. 30, 2013	Dec. 31, 2012
Current assets:
Cash and cash equivalents	$ 1,452,000	$ 1,450,000
Accounts receivable	0	7,000
Insurance recoveries receivable	0	3,265,000
Due from related parties	492,000	292,000
Other current assets	101,000	33,000
Total current assets	2,045,000	5,047,000
Investment in unconsolidated entities	265,000	246,000
Total assets	2,310,000	5,293,000
Current liabilities:
Accounts payable and accrued expenses	103,000	67,000
Obligations under capital lease	0	2,271,000
Asset retirement obligations	485,000	525,000
Total current liabilities	588,000	2,863,000
Deferred income taxes	97,000	362,000
Total liabilities	685,000	3,225,000
Commitments and contingencies
Stockholders' equity:
Common stock	78,000	78,000
Additional paid-in capital	3,101,000	3,100,000
Accumulated deficit	(1,554,000)	(1,110,000)
Total stockholders' equity	1,625,000	2,068,000
Total liabilities and stockholders' equity	$ 2,310,000	$ 5,293,000

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Florida Oncology Partners (Tables) (FOP and FOPRE [Member])

9 Months Ended

Sep. 30, 2013

FOP and FOPRE [Member]

Schedule of Equity Method Investments [Line Items]

Summarized Financial Information

The following tables present the aggregation of summarized financial information of FOP and FOPRE:

FOP and FOPRE Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013			2012
Patient revenue		$	2,120,000	$	2,322,000
Rental income		$	135,000	$	45,000
Net sales		$	2,255,000	$	2,367,000
Net income		$	185,000	$	375,000
USNC's equity in income of FOP and FOPRE		$	37,000	$	75,000
	Three Months Ended
		September 30,
			2013		2012
Patient revenue		$	651,000	$	839,000
Rental income		$	45,000	$	45,000
Net sales		$	696,000	$	884,000
Net income		$	81,000	$	189,000
USNC's equity in income of FOP and FOPRE		$	16,000	$	38,000

FOP and FOPRE Condensed Balance Sheet Information

	September 30,		December 31,
	2013		2012
Current assets	$	879,000	$	919,000
Noncurrent assets	$	5,958,000	$	6,374,000
Total assets	$	6,837,000	$	7,293,000
Current liabilities	$	1,178,000	$	965,000
Noncurrent liabilities	$	5,104,000	$	5,734,000
Equity	$	555,000	$	594,000
Total liabilities and equity	$	6,837,000	$	7,293,000

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The Southern California Regional Gamma Knife Center (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012
Schedule of Equity Method Investments [Line Items]
Renovation installation and operation agreement period			14 years
Neuro Partners LLC and CGK Condensed Income Statement Information [Abstract]
Patient revenue	$ 0	$ 617,000	$ 0	$ 1,681,000
USNC's equity in income (loss) USNC's equity in income (loss) of Neuro Partners LLC and CGK	(3,000)	23,000	9,000	8,000
CGK [Member]
Schedule of Equity Method Investments [Line Items]
Ownership percentage (in hundredths)	39.00%		39.00%
Neuro Partners LLC [Member]
Schedule of Equity Method Investments [Line Items]
Ownership percentage (in hundredths)	20.00%		20.00%
Neuro Partners LLC and CGK [Member]
Schedule of Equity Method Investments [Line Items]
Percentage of guarantee obligations (in hundredths)			20.00%
Period of lease with respect to gamma knife equipment and certain leasehold improvements			7 years
Outstanding balance on the lease obligations	2,456,000		2,456,000
Option to purchase the gamma knife	490,000		490,000
Neuro Partners LLC and CGK Condensed Income Statement Information [Abstract]
Patient revenue	253,000	294,000	856,000	810,000
Rental income	222,000	222,000	666,000	666,000
Net sales	475,000	516,000	1,522,000	1,476,000
Net income (loss)	(69,000)	(95,000)	(72,000)	3,000
USNC's equity in income (loss) USNC's equity in income (loss) of Neuro Partners LLC and CGK	(23,000)	(35,000)	(29,000)	5,000
Equity Method Investment Summarized Financial Information Balance Sheet [Abstract]
Current assets	522,000		522,000		468,000
Noncurrent assets	1,785,000		1,785,000		2,261,000
Total assets	2,307,000		2,307,000		2,729,000
Current liabilities	1,159,000		1,159,000		442,000
Noncurrent liabilities	1,829,000		1,829,000		2,896,000
Equity	(681,000)		(681,000)		(609,000)
Total liabilities and equity	$ 2,307,000		$ 2,307,000		$ 2,729,000

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The Southern California Regional Gamma Knife Center (Tables) (Neuro Partners LLC and CGK [Member])

9 Months Ended

Sep. 30, 2013

Neuro Partners LLC and CGK [Member]

Schedule of Equity Method Investments [Line Items]

Summarized Financial Information

The following tables present the aggregation of summarized financial information of Neuro Partners, LLC and CGK:

Neuro Partners, LLC and CGK Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013				2012
Patient revenue		$	856,000		$	810,000
Rental income			666,000			666,000
Net sales		$	1,522,000		$	1,476,000
Net income (loss)		$	(72,000	)	$	3,000
USNC's equity in income (loss) of Neuro Partners, LLC and CGK		$	(29,000	)	$	5,000
	Three Months Ended
	September 30,
			2013			2012
Patient revenue		$	253,000		$	294,000
Rental income			222,000			222,000
Net sales		$	475,000		$	516,000
Net loss		$	(69,000	)	$	(95,000	)
USNC's equity in loss of Neuro Partners, LLC and CGK		$	(23,000	)	$	(35,000	)

Neuro Partners, LLC and CGK Condensed Balance Sheet Information

	September 30,			December 31,
	2013			2012
Current assets	$	522,000		$	468,000
Noncurrent assets	$	1,785,000		$	2,261,000
Total assets	$	2,307,000		$	2,729,000
Current liabilities	$	1,159,000		$	442,000
Noncurrent liabilities	$	1,829,000		$	2,896,000
Equity	$	(681,000	)	$	(609,000	)
Total liabilities and equity	$	2,307,000		$	2,729,000

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The Southern California Regional Gamma Knife Center

9 Months Ended

Sep. 30, 2013

The Southern California Regional Gamma Knife Center [Abstract]

The Southern California Regional Gamma Knife Center

Note C – The Southern California Regional Gamma Knife Center

During 2007, the Company managed the formation of the Southern California Regional Gamma Knife Center at San Antonio Community Hospital ("SACH") in Upland, California.  The Company participates in the ownership and operation of the center through its wholly-owned subsidiary USN Corona, Inc. ("USNC").  Corona Gamma Knife, LLC ("CGK") is party to a 14-year agreement with SACH to renovate space in the hospital and install and operate a Leksell PERFEXION gamma knife.  CGK leased the gamma knife from Neuro Partners, LLC, which holds the gamma knife equipment.  In addition to returns on its ownership interests, USNC expects to receive fees for management services relating to the facility.

USNC is a 20% owner of Neuro Partners, LLC and owns 39% of CGK.

USNC is a 20% guarantor on Neuro Partners, LLC's seven-year lease with respect to the gamma knife equipment and certain leasehold improvements at SACH.  The outstanding balance on the lease obligations was $2,456,000 at September 30, 2013.  In 2016, Neuro Partners, LLC has the option to purchase the gamma knife for $490,000.

Construction of the SACH gamma knife center was completed in December 2008 and the first patient was treated in January 2009.  The project has been funded principally by outside investors.  While the Company has led the effort in organizing the business and overseeing the development and operation of the SACH center, its investment to date in the SACH center has been minimal.

Neuro Partners, LLC and CGK are considered to be variable interest entities of the Company.  However, as the Company is not deemed to be the primary beneficiary of Neuro Partners, LLC and CGK, since it does not have the power to direct the activities that most significantly affect their economic performance, certain disclosures are required rather than consolidation.

The Company has not recorded its share of the income (loss) of Neuro Partners, LLC and CGK due to the fact that the Company's share of cumulative losses has exceeded its investment in these entities.

The following tables present the aggregation of summarized financial information of Neuro Partners, LLC and CGK:

Neuro Partners, LLC and CGK Condensed Income Statement Information

	Nine Months Ended
	September 30,
	2013				2012
Patient revenue		$	856,000		$	810,000
Rental income			666,000			666,000
Net sales		$	1,522,000		$	1,476,000
Net income (loss)		$	(72,000	)	$	3,000
USNC's equity in income (loss) of Neuro Partners, LLC and CGK		$	(29,000	)	$	5,000
	Three Months Ended
	September 30,
			2013			2012
Patient revenue		$	253,000		$	294,000
Rental income			222,000			222,000
Net sales		$	475,000		$	516,000
Net loss		$	(69,000	)	$	(95,000	)
USNC's equity in loss of Neuro Partners, LLC and CGK		$	(23,000	)	$	(35,000	)

Neuro Partners, LLC and CGK Condensed Balance Sheet Information

	September 30,			December 31,
	2013			2012
Current assets	$	522,000		$	468,000
Noncurrent assets	$	1,785,000		$	2,261,000
Total assets	$	2,307,000		$	2,729,000
Current liabilities	$	1,159,000		$	442,000
Noncurrent liabilities	$	1,829,000		$	2,896,000
Equity	$	(681,000	)	$	(609,000	)
Total liabilities and equity	$	2,307,000		$	2,729,000

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Broward Oncology Partners (Details) (USD $)			3 Months Ended	9 Months Ended
	Sep. 30, 2013	Dec. 31, 2012	Sep. 30, 2013 Broward Oncology Partners, LLC [Member]	Sep. 30, 2013 Broward Oncology Partners, LLC [Member]	Jan. 31, 2013 Broward Oncology Partners, LLC [Member]
Schedule of Equity Method Investments [Line Items]
Investment in unconsolidated entities	$ 265,000	$ 246,000	$ 27,000	$ 27,000	$ 50,000
Ownership percentage (in hundredths)			12.50%	12.50%
Revenues				249,000
Net (loss)			(19,000)	(184,000)
Recorded investments	$ 265,000	$ 246,000	$ 27,000	$ 27,000	$ 50,000

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Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration (Details) (USD $)	9 Months Ended
	Sep. 30, 2013
Destruction of Gamma Knife at NYU Medical Center; Planning for Replacement and Restoration [Abstract]
Terms of agreement with NYU	12 years
Emergency removal cost	$ 525,000
Insurance coverage	930,000
Commitment for lease financing for replacement equipment and restoration	$ 4,600,000

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Income Taxes (Details) (USD $)	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Income Taxes [Abstract]
Federal and state income taxes, rate (in hundredths)	37.00%		37.00%
Income tax benefit	$ 69,000	$ 0	$ 265,000	$ 0

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Document and Entity Information	9 Months Ended
	Sep. 30, 2013	Nov. 13, 2013
Document and Entity Information [Abstract]
Entity Registrant Name	US NEUROSURGICAL INC
Entity Central Index Key	0001089815
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Filer Category	Smaller Reporting Company
Entity Common Stock, Shares Outstanding		7,797,185
Document Fiscal Year Focus	2013
Document Fiscal Period Focus	Q3
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2013